EURAMA | Applikation Form

For a New Dimension of Health Care

Application Form for Membership in EURAMA-European Ayurveda Medical Association

Family Name *
First Name *
Title
Date of Birth
Street
Postal Code
City
Country
Telephone
eMail *
Professional activity
Ayurveda education
Membership fee	€ (Membership fee 151.- € valid until end of the year.)
* Herewith, I am applying to become a member of EURAMA-European Ayurveda Medical Association. Your membership will become valid with the reception of the fee on the following bank account: Bank: Volksbank Ried im Innkreis / Österreich Recipient: EURAMA Acc.: 304 2801 0050 IBAN: AT694383030428010050 BIC/SWIFT: VBOEATWWRIE © 2008 EURAMA \| European Ayurveda Medical Association, all rights reserved.